Breast Cancer | Ian E Krop, MD, PhD

published 1 week ago by Dr Neil Love

Breast Cancer Update, Issue 2, 2019 — Part 1: Our interview with Dr Krop highlights the following topics as well as cases from his practice: Case: A patient in her late 40s with ER-positive, HER2-positive, node-positive breast cancer experiences a near complete response after treatment with neoadjuvant doxorubicin, cyclophosphamide, paclitaxel, trastuzumab and pertuzumab (AC-THP) (00:00) Choice of neoadjuvant chemotherapy for patients with HER2-positive breast cancer (01:43) Pertuzumab toxicity with or without chemotherapy (05:25) Management of the axilla in patients with clinically node-positive breast cancer who achieve a pathologic complete response to neoadjuvant systemic therapy (07:42) Design and results from the Phase III KATHERINE study evaluating adjuvant T-DM1 versus trastuzumab for patients with HER2-positive early breast cancer and residual disease after neoadjuvant treatment (09:46) Perspective on the benefits and risks of T-DM1/pertuzumab versus T-DM1 alone as adjuvant therapy (13:04) Benefit of T-DM1 compared to trastuzumab irrespective of the extent of residual disease at surgery in the KATHERINE trial (14:45) Clinical implications of the KATHERINE trial results (17:48) Results from the Phase III KRISTINE study evaluating neoadjuvant docetaxel, carboplatin, trastuzumab and pertuzumab (TCHP) versus T-DM1 and pertuzumab for HER2-positive breast cancer (19:42) Use of cold caps to reduce the risk of alopecia with chemotherapy (23:53) Side-effect profile of T-DM1 in the adjuvant KATHERINE trial (25:27) Perspective on the use of neratinib in the post-(neo)adjuvant and metastatic settings (29:42) APHINITY: Phase III study evaluating adjuvant pertuzumab in combination with trastuzumab and chemotherapy for HER2-positive early breast cancer (34:08) Biomarker analysis of the APHINITY trial: Genomic correlates of response to adjuvant pertuzumab with trastuzumab for HER2-positive breast cancer (36:15) Emerging data with immune checkpoint inhibitors in combination with HER2-targeted therapy for HER2-positive breast cancer (40:22) HER2 heterogeneity as a predictor of response to neoadjuvant T-DM1 and pertuzumab: Results from a prospective clinical trial (42:09) Changes in HER2 status during disease progression (45:50) Case: A woman in her early 60s with de novo ER-positive, HER2-positive metastatic breast cancer (mBC) experiences disease progression in the brain during treatment with T-DM1 (47:35) Activity of T-DM1 in patients with brain metastases (48:58) Efficacy and tolerability of tucatinib for HER2-positive mBC; ongoing Phase II HER2CLIMB study evaluating tucatinib versus placebo, each in combination with capecitabine and trastuzumab (52:41) Emerging data with neratinib and capecitabine for patients with HER2-positive breast cancer and brain metastases (55:23) Response to CDK4/6 inhibitors in patients with ER-positive, HER2-positive mBC (58:38) Case: A woman in her early 30s with HER2-positive mBC receives trastuzumab deruxtecan on a clinical trial after experiencing disease progression on multiple lines of therapy (1:02:42) Results of a Phase I trial of trastuzumab deruxtecan for patients with advanced HER2-positive breast cancer previously treated with T-DM1 (1:05:20) Benefits and risks of trastuzumab deruxtecan for advanced HER2-positive breast cancer (1:06:31) Response to trastuzumab deruxtecan in patients with breast cancer and low HER2 expression (1:09:03) Other novel agents and approaches under evaluation for HER2-positive breast cancer (1:13:15) CME information and select publications

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